Aug 17, 2021

A Clinician’s Take on Trauma-Informed ABA

Before starting any treatment, Dr. Kolu sits down with her clients and their support network to understand the outcomes that will make a real difference to that person’s quality of life. In her words:

Summary

Trauma-informed care is a journey that will look different for each person. Use these principles to get started on your journey:

Before starting any treatment, sit down with your client and their support network to understand the outcomes that will make a real difference to that person’s quality of life.
Consider the whole person. Are there any medical needs, any adverse experiences or complications that could affect your approach to treatment?
Recognize the barriers to collaboration and help your client and their support network work better together.

Trauma-informed care (TIC) is a trendy topic in the health and human services sector, especially when it comes to providing support to people with an intellectual or developmental disability (I/DD). Trauma is pervasive in this population and its impact on people’s health and wellbeing cannot be overlooked. We understand the importance of TIC but we don’t always know exactly what it looks like or the first steps to get started. If this sounds like you, know that you are not alone in feeling this!

“... It can be difficult to find providers who have received education and experiences on how trauma affects behavior.” - Dr. Camille Kolu.

A few years ago, Dr. Kolu shared her views with us on what it takes to bring a trauma-informed lens to her ABA practice. She spoke to us about making meaningful changes in someone’s life, how to be mindful of a person’s past, and why collaboration is always valuable. Dr. Kolu runs Cusp Emergence, a trauma-informed ABA practice, while teaching and training through Cusp Emergence University. It felt timely to bring this discussion back as trauma-informed care has become a hot-button item of conversation.

Step 1 - The Socially Significant Threshold

“If I help you change your behavior but it’s not enough to make a real difference in your life, we aren’t doing enough.”

“I want to measure your effective use of skills and increase that rate to a level

that is meaningful for you and YOUR life. I also need to measure and reduce how many times you are doing things that are hurting you. The actual numbers will depend on the individual and what is meaningful for them! We call this the “socially significant” threshold in behavior analysis.”

Before starting any treatment, Dr. Kolu sits down with her clients and their DRAFTJS_BLOCK_KEY:7ho2esupport network to understand the outcomes that will make a real difference to DRAFTJS_BLOCK_KEY:fp603that person’s quality of life. In her words:

One tool that Dr. Kolu uses to start understanding her clients is called a functional behavior assessment, or FBA for short. The goal of the FBA is to understand the meaning behind behaviors. Usually, this is targeted at behaviors that challenge.

In the context of trauma-informed care, one of the key objectives of the FBA is to appreciate the possible influences of aversive experiences in the person’s past or current environments that may offer an explanation for their behavior.

“Our early environments and experiences can make a big difference in the behaviors and skills we learn to use later, and they also make a difference in the kinds of things or people we want to approach or avoid later in life.”

Step 2 - Consider the Whole Person

In addition to conducting an FBA and evaluating a person’s past and current environments, Dr. Kolu also considers other factors that play a role in her

clients’ behaviors.

“Our ethical compliance code emphasizes the importance of ruling out medical needs or complications before treatment is provided so that we do not make things worse by acting on our assumptions”.

Step 3 - Recognize the barriers to collaboration

Collaboration is the key to success for any care team. Recognizing the barriers to collaboration early on will help you bring success to your client and their team.

Sometimes, the barriers can be attributed to a lack of time and resources. Other times, people’s history of trauma may prevent them from fully participating in the process.

“For a person who never learned to communicate pain because their initial attempts were punished or ignored, we can teach empowering advocacy and communication skills. I have seen this done even late in adulthood. It’s never too late to make the therapeutic environment more trauma-informed!”

Want to learn more?

Dr. Kolu takes the link between behavior and trauma very seriously. It is invaluable for understanding the full context of behavior. You can read the full interview with Dr. Kolu here.

Want to implement a trauma-informed approach into your care? Check out our How to Guide for Care Managers.